Smear layer and debris removal from dentinal tubules using different irrigation protocols: scanning electron microscopic evaluation, an in vitro study

Wang, Hsin-Hui; Sanabria-Liviac, D; Sleiman, Philippe; Dorn, Samuel O.; Jaramillo, David E.

doi:10.1186/s41121-017-0011-4

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…In the present study human extracted mandibular teeth of approximately the same dimensions were selected for standardization and their bulky roots which allow for easier splitting procedure with less risk of sample corruption which has been demonstrated in previous studies (18,19,20) . Crowns were not completely decoronated to ensure space for irrigation reservoir during cleaning, Standardized cavities were prepared to simulate internal root resorption using round bur at the same level from the apex this was to create equal, uniform cavities more over to ensure they were filled with the same amount of CGM (22,23) .…”

Section: Discussionmentioning

confidence: 97%

Efficacy of Combined Use of XP-endo shaper and XP-endo Finisher in Cleaning Simulated Internal Root Resorption Defects: An In-Vitro Comparative Study

Moukarab

2019

Egyptian Dental Journal

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Aim: Evaluate the efficacy of the combined use of XP shaper and finisher in cleaning simulated internal root resorption defects in comparison to the conventional passive ultrasonic irrigation using stereomicroscope. Materials and methods: The root canals of 90 freshly extracted human mandibular premolars were prepared using Protaper up to F4 and the teeth were split longitudinally and semicircular cavities (simulated internal root resorption cavities) were prepared in the canal wall on each half of the roots, then randomly assigned into two experimental groups (n=40) according to the cleaning technique groups (A) cleaned using passive ultrasonic irrigation , group (B) cleaned using XP-endo shaper followed by XP-endo finisher , five specimens were assigned to serve as negative control and five more were assigned to serve as positive control. Colored gelatin material (CGM) was prepared and applied into the semicircular cavities except for the negative control which did not receive (CGM). The root halves were reassembled creating a circular simulated resorption cavity within the root canal. Specimens were cleaned according to the group they were assigned to except for the positive control which did not receive any further treatment. All the specimens were disassembled and the residual CGM was examined under a stereomicroscope at 10x magnification and calculated as percentage of residual CGM to total area of the IRR cavity by using image analysis software and the data were statistically analyzed with one-way ANOVA test and significance level was set at P > 0.05. Results: None of the tested methods could completely remove the CGM from the simulated IRR cavities. Group B showed lower mean percentage of residual CGM than did group A (P0.041 >). Concussion: within the limitations of this study XP-endo shaper followed by XP-endo finisher was more effective in cleaning inaccessible internal root resorption defects than PUI.

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Section: Discussionmentioning

confidence: 97%

Efficacy of Combined Use of XP-endo shaper and XP-endo Finisher in Cleaning Simulated Internal Root Resorption Defects: An In-Vitro Comparative Study

Moukarab

2019

Egyptian Dental Journal

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“…Canal disinfection requires chemical preparation as well as mechanical preparation. Canal disinfection substantially relies on irrigants because of the anatomic complexities of the pulp canal system [46]. Mechanical preparation will result in smear layer formation and chemical preparation will disinfect the parts that cannot be reached mechanically [47].…”

Section: Methods Of Smear Layer Removalmentioning

confidence: 99%

“…EDTA decalcifies dentin to an extent of 20-30 µm in 5 min [52]. The appropriate time for EDTA application to remove smear layer is about two minutes, but the thicker the smear layer is, the longer time of exposure should be [46]. MTAD (Mixture tetracycline citric acid and detergent) is a potent intracanal irrigant in regards to smear layer removal.…”

Section: Methods Of Smear Layer Removalmentioning

confidence: 99%

Smear Layer in Endodontics: A review of its role and management

Abognah

2020

KJDMR

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Whatever the technique used for root canal instrumentation; a layer of debris termed “smear layer” is formed. This is a layer composed of an organic and inorganic substance and it harbors bacteria and their by-products. Removing the smear layer enhances the cleaning and disinfecting of root canal walls and grant maximum adaptation of root canal filling materials. Nonetheless, the existence of smear layer can seal the dentinal tubules and decrease the probability of dentinal tubule’s invasion by bacteria and their toxins, this issue is still controversial. Smear layer removal approaches including chemical, ultrasonics, and laser have been widely studied. However, none of them is entirely efficient along the length of all canals or is universally recognized. If the decision was to remove smear layer, irrigating root canals with EDTA followed by NaOCl will fulfill the objective. It is still debatable whether the removal of smear layer will decrease the apical leakage or not. Additional research is required to determine the consequence of removing or preserving the smear layer.

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“…EDTA and NaOCl have been shown to be more effective in disinfecting and cleaning dentinal tubules when used sequentially than when used as independent agents. Wang et al [16] demonstrated that alternating the use of NaOCl and EDTA with water in between is more efficient in keeping dentinal tubules open during cleaning and shaping procedures that when using NaOCl or EDTA alone. While EDTA does not possess significant antimicrobial properties, it can enhance the effectiveness of other antimicrobial agents by allowing their dissemination into otherwise inaccessible dentinal tubules that can potentially harbor microorganisms [17].…”

Section: Introductionmentioning

confidence: 99%

Dentin Disinfection Efficacy Using Four Different Irrigation Protocols

Jaramillo

Ibarrola

Arias

et al. 2021

DRM

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Objective: The objective of this study was to observe the effect that 3% Sodium Hypochlorite and 17% Ethylenediamine Tetraacetic Acid (EDTA) with water in between, used sequentially and individually had in the disinfection of dentin blocks that were contaminated with Enterococcus faecalis. Materials and Methods: Thirty apical and coronal dentin block samples were divided into five groups (n=5): All samples were inoculated with Enterococcus faecalis Group 1: Samples were submerged in 3% NaOCl then in 17% EDTA. Group 2: Samples were submerged first in 17% EDTA and then in 3% NaOCl. Group 3: Samples were immersed in 3% NaOCl only. Group 4: Samples were submerged in 17% EDTA only. Group 5 (positive control group): Samples were only submerged in distilled water. All samples were submerged in distilled water after each irrigation cycle. The irrigation protocol was repeated in all groups until all dentin samples were exposed to 24ml of the irrigating solutions. CFU units were counted and classified in an ordinal scale and compared with the linear-by-linear association test. Results: A significant linear trend in the reduction of CFU was observed when NaOCl and EDTA were combined (independently of the sequence used) when compared to groups 3 and 4 where the irrigants were used individually both in coronal (p=9.45 x 10-21), and apical slices (p=2.33 x 10-20). NaOCl was significantly more effective than EDTA in both coronal and apical slices (p ≥ 0.000001) when used alone. Conclusion: 3% Sodium Hypochlorite was more effective than 17% EDTA. However, alternating 3% NaOCl with 17% EDTA resulted in better dentinal disinfection. Clinical Relevance: Establishing an irrigation protocol that is effective in eradicating bacteria entrenched in dentinal tubules can lead to a more successful outcome in endodontically treated teeth.

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Smear layer and debris removal from dentinal tubules using different irrigation protocols: scanning electron microscopic evaluation, an in vitro study

Cited by 6 publications

References 15 publications

Efficacy of Combined Use of XP-endo shaper and XP-endo Finisher in Cleaning Simulated Internal Root Resorption Defects: An In-Vitro Comparative Study

Efficacy of Combined Use of XP-endo shaper and XP-endo Finisher in Cleaning Simulated Internal Root Resorption Defects: An In-Vitro Comparative Study

Smear Layer in Endodontics: A review of its role and management

Dentin Disinfection Efficacy Using Four Different Irrigation Protocols

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